A STUDY ON
“KANAM”
Dissertation Submitted To
THE TAMILNADU Dr.M.G.R MEDICAL UNIVERSITY Chennai – 32
F or the P artial fulfillm ent in A w arding the D egree of
DOCTOR OF MEDICINE (SIDDHA)
(Branch – IV, Kuzhanthai Maruthuvam)
Department of Kuzhanthai Maruthuvam Government Siddha Medical College
Palayamkottai – 627 002 APRIL - 2012
Acknowledgement
ACKNOWLEDGEMENTS
I express my whole hearted thanks to The Vice – Chancellor, The Tamilnadu Dr. M.G.R. Medical University, Chennai and The Commissioner of Indian Medicine and Homeopathy for permitting me to do this dissertation.
The author wish to thank The Joint Director of Indian Medicine and Homeopathy Department, Chennai, for giving due recognition for the dissertation work.
I would express my deep gratitude to Prof. Dr.N.Chandramohandoss M.D(S)., Principal, Govt. Siddha Medical College, Palayamkottai for having
permitted to make use of facilities available in the college.
I thank to Prof. Dr.S.Soundharajan M.D(S) B.L., Vice Principal, Govt.
Siddha Medical College, Palayamkottai.
I express my whole hearted thanks to Asso.prof, Dr.S. Kaniraja M.D(S)., Head of the department. Department of P.G. Sirappu Maruthuvam, Govt Siddha Medical College, Palayamkottai for his valuable guidance in this study.
I cordially thank to Dr.D.Rajasekar M.D(S)., Lecturer and Dr.A.S.
Poonkodi Kanthimathi M.D(S)., Lecturer. P.G. Sirappu Maruthuvam
department, Govt. Siddha Medical College, Palayamkottai for their suggestions in this work.
It is the author’s duty to place a record of profound sense of gratitude to Dr. S. Ramaguru, B.SC.,M.S(Ortho)., D.Ortho., Part time professor of
I also thank to Dr.S.Bagirathy, MBBS., and all the Technicians of Clinical Pathology Department for giving a kind co-operation in doing investigation process.
I also thank Prof. Mrs.N.Nagaprema M.Sc., and other staff in the Department of Bio Chemistry for their co-operation in bio-chemical analysis of the medicine.
I would also thank Mr.M.Kalaivanan M.Sc., Lecturer and other Staff of Modern Pharmacology Department to bring out the efficacy of the trial medicines.
I also thank Librarian Mrs.T.Poonkodi M.A., M.L.I.S., M.Phil., for lending books for reference whenever required.
SL.
NO CONTENTS PAGE
NUMBER
1. INTRODUCTION 1
2. AIM AND OBJECTIVES 5
3. REVIEW OF LITERATURE
a. Siddha Aspect 6
b. Modern Aspect 37
4. MATERIALS AND METHODS 74
5. RESULTS AND OBSERVATION 79
6. DISCUSSION 101
7. SUMMARY 108
8. CONCLUSION 109
ANNEXURE
1. Preparation and properties of trial drugs 110
2. Bio–Chemical Analysis 118
3. Pharmacological Analysis 121
4. Assessment forms 130
BIBLIOGRAPHY 148
Introduction
INTRODUCTION
Medicine is an art of fundamental to the health survival of humanity.
Siddha system is one of the ancient systems of medicine in the world. This system of medicine developed with in the Dravidian culture, which is of pre- vedic period.
The Siddhars says that the universe is the composition of mann, neer, neruppu, kaatru and aakayam. The human body, pathology of disease, medicine for treatment, and food substances all are have this composition of five elements ie, mann, neer, neruppu, kaatru and Aakayam.
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Paediatrics in Siddha System:
In siddha system, the paediatric medicine known as Balavagadam or Kuzhanthai maruthuvam.
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Siddhars had a vast classification of diseases. They had known that iseases attack the child from his fetal life and classified under “Karuvil Thondrum Noigal”. Kanam is one of the karuvil thondrum noigal.
Infections diseases and nutritional deficiencies are the twin problems among the health problems of children affecting their growth and development. Particularly in developing countries like India, Paediatric kanam is one of the commonest diseases.
Clinical features of kanam explained in Siddha system are related to childhood type of tuberculosis in modern system.
Aim and Objectives
AIM AND OBJECTIVES
Kanam is one of the most common illnesses of children. It is one of the major medico social problems in most of the developing countries like India.
I have much interested to give a new Drug to our paediatric branch for kanam. My trail Drug is “Elai Erumal CHOORANAM” from the reference book of the pharmocopeia of Siddha Research Medicine. P.No: 109.
OBJECTIVES:
The main objective of the study is to create awareness about Siddha System and efficacy of the Siddha Drugs.
To collect the symptoms and signs of kanam in various Siddha literatures.
To make a comparative study of kanam with modern aspect.
To conduct a through clinical study on ‘kanam’ with ‘Elai Erumal CHOORANAM’.
To explore the efficacy of drug for kanam with less adverse effects.
To evaluate the disease kanam clinically by etiological factors, clinical features, differential diagnosis, investigation, diagnosis, treatment, diet, prognosis and complications.
To evaluate the pharmacological study of the trial drug.
To study the bio-chemical analysis of the trial drug.
To evaluate the Antimicrobial actvity of the trail medicine.
To educate the parents and children who were affected by the disease and how to stabilize their health through natural way like panayama, food restrictions and personal hygiene.
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!
Lg<Gx<x!OuXhiMgt<;!MUKKUTRA VERUPADUGAL
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!
Lg<Gx<x!fqjzgt<;!MUKKUTRA NILAIGAL:
Vali:
Site of vadham in body: uikl<!uiPlqml<!
! Abaanan, faeces, idakalai, below the umblical region, spermatic cord, Pelvic bones, skin, Nerve plexus, joints, hair follicle, muscle, alimentary tract, bones, Ear and thighs.
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Vadham consists of 10 types 1. Praanan: (Uyirkaal)
This controls knowledge, mind and five sense organs, which are useful for breathing and digestion. In kanam, this vayu is affected leading to dyspnoea. (Difficulty in breathing) and poor appetite.
2. Abaaban: (Keezh nokkung kaal)
This is responsible for all down ward movement such as passing urine, stools, semen, menstrual flow. In kanam, this vayu is affected because some patient had diarrhoea.
3. Samaanan: (Nadukkaal)
This aids in proper digestion and controls other vayus.
In kanam, this vayu is altered leading to poor appetite and cannot
4. Viyaanan: ( Paravukaal)
This is responsible for all movements of all parts of the body and distribution of saaram.
In kanam, this vayu is affected because of decreased activity due to symptoms and gradual emaciation due to improper distribution.
5. Uthaanan: (Mel Nokkung kaal)
Responsible for all upward visceral movements such as vomiting and Nausea. Then distributes the saaram equally to all tissues.
In kanam, it is affected because saaram cannot equally distributed. It results in emaciation malnourishment.
6.Naagan:
Responsible for opening and closure of eye lids and is not affected in kanam.
8/!Koorman:
Responsible for vision and yawning In kanam, it is not affected.
8. Kirukaran:
This is responsible for salivation, nasal secretion, sneeze, cough and maintains the appetite. In kanam, this is affected because cough, running nose and poor appetite present.
9. Devathatthan:
This is responsible for tiredness (Laziness), anger and emotional expression.
In kanam, this vayu is deranged because some patient had tiredness.
10. Dhananjeyan:
It produces swelling of the body after death. It escapes on the third day after death bursting out of the cranium.
! )Poor appetite is the predominant symptoms of kanam. Thus among the Dhasavayus this symptom mainly affects the vayus like samaanan, praanan, kirukaran).
- sqk<k!lVk<Kuir<g!SVg<gl<!)h/w{<;!253.25:*/!
Azhal:
Sites of pitham in body:
Pinkalai, praanavayu, urinary bladder, moolakkini, heart, Head, umblical region, stomach, sweat, saliva, blood, saaram, eyes and skin.
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!
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Pitham consists of 5 types 1. Anal pitham:
It promotes appetite and helps in digestion.
In kanam, maximum patient complained poor appetite.
2. Ranjagam:
It gives colour to the blood.
3. Saadhagam:
It is important for day to day activities with the help of mind and brain.
4. Praasagam:
It gives complexion to skin In kanam-Normal.
5. Aalosagam:
It brightens eyes and responsible for clear vision.
In kanam-Normal.
- sqk<k!lVk<Kuir<g!SVg<gl<!)h/w{<;!266.268*/
Iyam:
Sites of Kabam in body:
Kabam (or) kapham is located in sammanavayu Suzhumunai, sperm, head, tongue, uvula, fat, bone marrow, blood, nose, chest, nerve, bone, brain, Large intestine, Eyes, joints and also present in throat, stomach and Pancreas.
! ! .sqk<k!lVk<Kuir<gs<!SVg<gl<!)h/w{<;269*/!
Kabam consists of five types 1. Avalambagam:
It lies in the lungs. It controls the heart and other four kabams.
In kanam, it is deranged because patient has cough and dyspnoea.
2. Kilethagam:
It lies in the stomach and gives moisture to food material and also helps for digestion.
In this diseases, it is affected because poor appetite present in children.
3. Pothagam:
It lies in tongue and responsible for taste sensation. it is affected in kanam due to ulceration of tongue leads to altered taste sensation.
4. Tharpagam:
It present in the head and responsible for coolness of both eyes.
In kanam. it is affected because changes in natural eye colour (redness).
5. Santheegam:
It present in joints, Responsible for lubrication and free movements of joints.
It kanam-It is normal.
-sqk<k!lVk<Kuir<gs<!SVg<gl< (h/w{<;!272.274*/!
Piniyari Muraimai: (Diagnosis)
Piniyari muraimai is a method of diagnosing a disease. The way of diagnosis is very important by a physician can deal the disease, then only he or she will ruleout the cause of disease. This is the main thing for the treatment.
-kjeOb?!kqVut<TuI!kqVg<Gxtqz<!hqe<uVliX!%XgqxiI/!
! “Ofib<fic!Ofib<Lk!eicbK!k{qg<Gl<!
! uib<fic!uib<h<hs<!osbz<”!
! ! ! ! ! .!kqVg<Gxt</!
Siddha system has a very unique method for diagnosis. This is based upon three principles.
1. Poriyaal arithal (Inspection) 2. Pulanaal arithal (Palpation) 3. Vinaathal (Interrogation) 1. Poriyaal arithal:
Porigal are the five organs of perception. Ther are Eyes, Ears, Nose, Tongue and skin. Poriyaal arithal is examining the Pori of the patient by the
Mei (skin) - Normal
Vaai (Tongue) - Affected (sometime dryness of the tongue present) Kann (Eye) - Sometime affected (redness)
Mookku (Nose) - Affected (Running Nose) Sevi (Ear) - Normal
2. Pulanaal arithal:
That means understanding by the sense objects.
Ooru (sensation) - Affected (sometime fever) Oosai (sound) - Normal
Oli (vision) - Normal
Suvai (Taste) - Affected due to ulceration of the tongue Naatram (smell) - Altered or absent due to Running Nose.
3. Vinaathal:
By vinaathal, the physician knows about the patients Name, age, occupation, Family, history, socio-economic status, Diet, complaints, History of previous episodes, Frequency of episodes, Relevant history of treatment & habits.
Ezhu udar kattugal and Ennvagai thervugal are used for diagnosis.
EZHU UDAR KATTUGAL:
Annamaya kosam is constituted by seven thathus. They are the basic tissues of our body.
Seven udar kattugal are:
1. Saaram 2. Senneer 3. Oonn 4. Kozhuppu 5. Enbu
7. Sukkilam/suronitham
When the seven udar Kattugal ae increase or decrease from the normal level, the normal functions of the body will be affected.
IN KANAM:
1.Saaram : Deranged due to poor appetite causing tiredness.
2. Senneer : Deranged in some patient with nutritional anaemia.
3. Oonn : Deranged of poor appetite leads to gradual emaciation.
4. Kozhuppu: Deranged , due to emaciation the energy is derived from fat stored in the adipose tissues.
5. Enbu : Deranged, because nutritional deficiency developed due to poor appetite. So the bones becomes
strengthless and results in pigeon chest formation.
6. Moolai : Deranged in severe cases.
7. Sukkilam/ Suronitham : It is normal
ENNVAGAAI THERVUGAL: Eight tools of diagnosis
It is the basic diagnostic principles and the uniqueness of the siddha system of medicine. The following lines are said about this.
“olb<g<Gxq!fqxf<okieq!uqpq!fiuqVlz<!jgg<Gxq”!
!! .!sqk<k!lVk<Kuir<gs<!SVg<gl<!)h/w{<;594*/!
“fich<hiqsl<!fifqxl<!olipquqpq!
lzl<!&k<kqvlqju!lVk<Ku!viBvl<”!
! ! ! .!Ofib<!fimz<!Ofib<!Lkeimz<!)h/w{<;381*/!
“Okcb!uqbikqg<!ogz<zl<!Okgk<kqz<!hiqm<jsB{<M!
%cOb!fqx<Golm<M!hiqm<jsbir<!%xg<OgtQI!
ficOb!okim<mix<!Okgl<!&k<kqvl<!uiIk<jk!g{<gt<!fig<G!
hicOb!lzszr<gt<!hz!u{<{l<!hiIk<Kg<!ogit<Ot”!
The diagnostic value of ENN VAGAI THERVUGAL is specific to siddha system of medicine.
Enn vagai thervugal are:
1. Naadi (Uyir thathu)
2. Sparisam (Touch feel sensation) 3. Naa (Tongue)
4. Niram (Colour of the skin)
5. Mozhi (Quality and character of speech) 6. Vizhi (Eye)
7. Malam (Stools) 8. Moothiram (Urine) a. Naadi (Uyir thathu)
Otherwise known as uyir thathu, is the principle method for diagnosis in siddha system. The Naadi indicates the status of the body thathus and the body is normal or abnormal. It is responsible for existence of life in the physical body. It is said in Tamil as
dmzqz<! dbqIkiqk<kqVh<hkx<G! giv{lie! sg<kq! wKOui! nKOu!
“kiK!nz<zK!fic”!weh<hMl</!
!
Naadi Nadai in KANAM:
The prime factor, the kabam is involved in kanam and is accompanied with vitiated vadham or pitham and produce clinical symptoms of kanam.
This is clearly indicated by theraiyar as.
“ghk<kqje!be<xq!gis!Suisl<!gi{iK”!
.!Okjvbi<?!hq{qgtqe<!Lkx<giv{l</!
But in childrens the Naadi Nadai is not clearly seen. This is indicated by following lines.
! Gxqh<higs<!sqx<xqe<hl<!osb<k!Ohi<gt<!
! n{<cmOu!kiqk<kqvIgt<!uqVk<kI!hizi<
! ne<higk<!k{<{Qiqz<!&p<gqOeiIgt<!
! ogi{<cmOu!-ui<gtK!dXh<hqe<!kiK!
! %xOu!LcbiK!wui<g<Gg<!gqm<Ml<”!
! ! ! ! .!Ofib<fimz<!Ofib<!Lkeimz<!)h/w{<;282*/!
But in the text book Noinaadal Noi mudhanaadal Naadinadai of kanam given as follows:
Vadha kabam Pitha kabam Kabanaadi Kaba vadham Kaba pitham
1.!Vadhakabam : (uikghl<*
“hir<gie!uikk<kqz<!Osk<Kl!fich<!
! ////////////////////////////////////////////////////////////////////!
! uir<gik!=jtlf<!kiv!gisl<!
! uzqBmOe!HxuQs<S!dt<uQs<S!uQg<gl<”!
3/!Pithakabam : (hqk<kghl<*
“h{<hie!hqk<kk<kqz<!Osk<Kl!fic!
! hiqsqk<ki!zk<kqSv!lqjth<H!=jt”! ! ! 4/!Kaba Naadi : )ghfic*!
“kieLt<t!Osk<Klf<ki!eqtgqz<!ouh<H!
! sblQjt!-Vlz<lf<!kiv!gisl<”!
5/!Kaba vadham :!)ghuikl<*!
“g{<miObi!sqOzx<hek<kqz<!uikfic!
! /////////////////////////////////////////////////////////////////////////!
6/!Kaba pitham :!)gh!hqk<kl<*!
“-mlie!Osk<Klk<kqz<!hqk<kfic!
! ////////////////////////////////////////////////////////////////!
! kqmlie!Gtqi<!gib<s<sz<!lR<st<!OfiUk<!
! Okgk<kq!Zjts<szqjth<!hqVlz<!uif<kq”!
! ! ! ! ! .!Ofib<fimz<!Ofib<!Lkeimz</!
b. Sparisam: (Touch feel sensation)
Identify the heat or coldness of the body, pain & skin nature (soft or Hard)
In kanam,
• It may be hot due to fever.
• It may be cold due to sweating.
c) Naa: (Tongue)
It is noted for colour of the tongue local lesion (ulceration, Redness), coating deposition of tongue & dryness of the tongue.
In kanam patients have ulceration & dryness of the tongue.
d. Niram: (Colour of skin)
Colour of skin, conjuctiva, teeth, tongue, nail bud and hair.
In kanam conjuctiva, nail bud may be pale due to nutritional anaemia.
Tongue become redcolour due to ulceration.
Skin may be black in some children.
e) Mozhi : (Quality and character of speech)
Observation of speech and voice. This is said in Agasthiar vallathi.
“uiIk<jkjbh<!hiI”!
In kanam Hoarseness of voice present.
f) Vizhi : (Eye)
Colour of eye (redness, Pallor) protrusion, tears, excreta of eye,
In kanam, the eyes may be red in some patients. Same patients have pallor of lower eyelid due to nutritional anaemia.
9. Malam : (stools)
Consistency of stool (Hard or semisolid), diarrhoea undigested food, fluid resembling the water used for cleaning the meat, colour, froth dysentery, bloody, pus, mucous, smell, frequency of defeacation, constipation, quantity of stool are noted.
In kanam, patient have different symptoms ie, sometime fluid resembling the water used for cleaning the meat, Bloody diarrhoea and pus and mucous are present in stool. Stools are oily in nature in some patients.
b) Moothiram : (Urine)
Colour of urine (yellow, Black, white copper colour, mixed colour.
Then smell of urine (smell of fire, honey, sweet odours, fruity odour) Frothy or not, frequency of urination and quantity of urine are noted.
In kanam colour of urine is dark yellow in some patients & straw yellow in some patients. Quantity of urine is decreased in amount.
Neer nira kuri and Nei kuri:
This urine examination is unique in siddha system of medicine.
fQIfqxg<Gxq;!
! “nVf<K!lixqvkLl<!nuqOviklkib<!
! n0gz<!!nzi<kz<!ngizU,e<!kuqIf<kpf<!
! Gx<xtuVf<kq!dxr<gq!jugjx!
! Ncg<gzsk<!kiuqOb!giK!ohb<!
! okiVL%Ik<kg<!gjzg<Gm<hM!fQiqe<!
! fqxg<Gxq!ofb<g<Gxq!fqVlqk<kz<!gmOe”!
! ! ! ! .!Ofib<!fimz<!Ofib<!Lkeimz<!)h/w{<;393*/!
Collection of sample urine:
The patient must take well cooked food in the previous day. Food intake should be taken at correct time and avoid excessive intake. The urine is collected on the down of the next day in a pure glass container and closed immediately to prevent contamination. This specimen must be examined with in one and half hours of from the collection.
ofb<g<Gxq;!
!!!“fqxg<Gxqg<!Gjvk<k!fqVli{!fQiqx<!
! sqxg<g!ou{<o{b<ObiI!sqXKtq!fM!uqMk<!
! oke<Xxk<!kqxf<okizq!Wgikjlk<kkq!
! eqe<xkqujz!Ohil<!ofxquqpqbxqUl<!
! ose<xK!HgZf<!osb<kqjb!B{Ov”!
! ! ! ! .!Ofib<!fimz<!Ofib<!Lkeimz<!)h/w{<;3:9*/!
A drop of gingelly oil is dropped on a wide glass vessel containing the urine to be tested which is kept under sunlight in a calm place. The derangement of three dhoshas can be diagnosed by the mode of spread of gingelly oil on the surface of urine.
In kanam the results of Nei kuri is pearl like oil floating on urine in some patients and ring like structure on urine in some patients.
MARUTHUVAM:
The treatment in Siddha Medicine is aimed at keeping the three kutrams in equilibrium.
ie,
Highly vitiated pitham to normal level Vitiated kabam to normal level
Vitiated vadham due to vitiated pitham to normal level.
To strengthen the seven udar kattugal and maintains the normal level.
Keeping in mind the need for bringing out an effective therapy for kanam from siddha system of medicine, I have undergone this dissertation work with ELAI ERUMAL CHOORANAM.
This medicine is effective and safe for paediatric usage.
The dosage of medicine in different age group.
1 - 2 yrs - 125 mg tds with honey 3 - 7 yrs - 250 mg tds with honey 8 - 12 yrs - 500 mg Bd with honey Line of treatment:
Siddha treatment is not only for complete healing but also prevention and rejuvenation. Poet Thiruvalluvar says about physician’s duty as follows:
“Ofib<fic!Ofib<!Lkz<fic!nK!k{qg<Gl<!
! uib<fic!uib<h<hs<!osbz<”
!
! “dx<xie!tUl<!hq{qbtUr<!gizLr<!
! gx<xie<!gVkqs<!osbz<”!
! ! ! ! ! ! .!kqVg<Gxt</!
! So essential to know the disease, the etiology, the nature of patients, severity of the illness, the seasons and the time of occurrence must be observed clearly.
Line of treatment is as follows:
1. Kaappu (prevention) 2. Neekkam (Treatment) 3. Niraivu (Restoration) 1. Kaappu: (prevention)
Prevention is the main aim of Siddha system. Siddhars have described general preventive measures and special measures.
Especially in Balavagadam, special preventive measures said for prevention of disease of the child. It starts from the conception and goes on the child grows up in intra uterine life and after delivery.
ie, Diet of pregnant women, her habits, medicine to take in every month of pregnancy, her psychological conditions & surroundings.
2. Neekkam: (Treatment)
The aim of treatment is based on
To bring the three thoshams into normal equilibrium state.
To treat the patient according to the symptoms by internal medicine.
Elai erumal CHOORANAM Anupanam in siddha system :
“nEhiek<kiOz!buqp<kl<!hzqg<Gl<!
-eqkie!Sg<G!ge<ez<!-R<sq!.!hqELkgiz<! !
OgiOlbl<!hiz<!Ljzh<hiz<!Ogiofb<!Oke<!oux<xqjz!fQI!
Nlqjk!bivib<f<K!osb<bzil<”!
- Okjvbi<!ou{<hi/!
!! Siddha system considers anupanam as an important. It is otherwise known as “Thunai marunthu”, it can be translated as vehicle, adjuvant &
supporting to drug therapy. Without anupanam, success in the treatment is mostly not possible.
Pathiyam:
During the course of treatment, the patients were advised to follow certain restrictions regarding diet and physical activities.
This type of medical advice system termed as pathiyam. Importance of pathiyam is said by Theraiyar as follows.
“hk<kqbk<kqeiOz!hzE{<miGl<!lVf<K!
! hk<kqbr<gt<!Ohieiz<!hze<!OhiGl<.hk<kqbk<kqz<!
! hk<kqbOl!oux<xqkVl</!!h{<cki<g<G!Nkzqeiz<!
! hk<kqbOl!dk<kqobe<X!hiI”!
! ! ! ! ! ! .!Okjvbi<!ou{<hi/!
! The patient with kanam advised to avoid cool drinks, cold water and exposure to chill weather and allergens.
3. Niraivu: (Restoration)
Reassurance of disease recovery was given to all patients.
All the patients are advised to prepare for lifestyle that provides a disease free life.
Diet:
Siddhars advise the diet regimens for kanam patients. They are explained below:
“gk<kqiq!Ohb<Hmz<!ujv!bqVhigz<!hVr<giti!g{<mgiiq!
! nk<kqg<! gib<gTl<! uVg<jglihbx<jx! gjvbiz<! hQIg<gVl<!
hqR<SOui<!
! olib<k<k!$v{r<!gkzqk<!k{<Mgjth<!H,Ltr<gq!LVg<gVl<Hl<!
! nk<kq!H,s{qg<!gibVt<tq!ut<tqBr<!ghk<OkiIg<!gi{liOl”!
- hkiIk<k!G{!sqf<kil{q/!
!
“Oujt!l{k<kg<gitq!ole<sQjk!sg<gvui<k<k!
! hQjt!usjz!Sg<G!oh{<g{r<gt<!.!Oujtbqz<!
! osf<ktqI!gjtg<gQjv!osb<ui<!ghOkgI!fqkl<!
! uf<ktqB{k<kie<!lgqp<f<K”!
! ! ! ! ! .!hkiIk<k!G{!sqf<kil{q/!
gib<gxqgt<;!
gk<kiq!
Ohb<Hmz<!
nujv!
g{<mr<gk<kqiq!
nk<kq!
hQIg<G!
liuM!
uijpg<gib<!
LVr<jg!
S{<jm!
!
OuIg<gqpr<Ggt<;!
Lt<tr<gq!
=Vt<tq!
-R<sq!
gVj{k<k{<M!
!
gQjvgt<;!
l{k<kg<gitq!
giqsijz!
sqXg{<hQjt!
usjz!
sqXgQjv!
l{zqg<gQjv!
hvm<jmg<gQjv!
Htqbijvg<gQjv!
!
Diet Restriction:
Siddhars advise to avoid certain food items during diseased conditions
“gMG!fx<xqzk<!ok{<o{b<!%p<hi{<mr<!gmjz!
! uMu!kigqb!okr<Gli!uVg<jg!fx<gib!
! lMuq!zikout<!Tt<tqogit<!Hjgbqjz!lKoh{<!
! -mX!higOui!hgk<kq!fQg<gmzqs<!sihk<kqbl<”!
! ! ! ! .!Okjvbi<!ou{<hi/!
These are general diet and habitual restrictions for all diseases. Kanam patients should restrict the following items also.
Jaggery Curd Butter Ghee Fish Dry fish
Watery vegetables & fruits.
Prevention Methods:
The patients were advised.
To findout which agent makes allergy and avoid them To avoid chill and cold weather
To avoid cool drinks and ice creams To avoid contaminated food and water
To take highly nutritious diet to get their immunity developed.
Advice to practice pranayamam (Children above 7 yrs who are able to under stand and follow the instructions are advised)
PRANAYAMAM (Breathing Exercise)
Pranayamam or breathing exercise mainly consists of Pooragam (inhalation of air by deep inspiration), Kumbagam (holding the breath as far
By this exercise, the duration of Kumbagam is increased. This results in proper gaseious exchange which provides increased oxygen supply to the cells.
By the regular practice of Prahnayamam, one can get a feeling of reduced both metntal and physical stress and enjoy pleasure. It provides good concentration and meditation. This practice also gives good appetite, strength, enthusiasm and vitality.
During breathing exercise, the lungs expand well and get proper supply of oxygen by proper expansion of chest. So, Prahnayam practice is one of the prevention for kanam.
This pranayama is advised to the children above 7 years of age, who can understand the technique of doing the practice. The parents are advised to encourage their children to do the practice regularly.
“fiotie<Xg<G!-Vhk<Ovivibqvk<K!nXE~X!
! ! fzlie!Suisf<kioe!Pf<kqvg<Gl<!
! Ogiotie<xqh<!hkqeizibqvk<K!fiE~X!
! ! Guqf<k!&zikivk<Kt<!otiMr<Gl<!
! hiotie<xq!Obpibqvk<kqVF~X!Suisl<!
! ! hipqeqx<!hib<f<kqMole<!xxqgh<hqe<je!
! Wotie<xq!bqkjeOb!Bm<sikqk<kiz<!
! ! wh<ohiPKl<!hizvi!bqVg<gziOl”!
! ! ! ! ! ! ! .!B,gq!juk<kqb!sqf<kil{q!
!
!
PRANAYAMAM
!
!
Modern Aspect
MODERN ASPECT ANATOMY OF RESPIRATORY SYSTEM:
Respiratory tract consists of following organs Nose
Pharynx Larynx Trachea
Two bronchi (one bronchus to each lung) Bronchioles and smaller air passages.
Two lungs and their coverings, the pleura
Muscles of respiration the intercostal muscles and the diaphragm.
PHYSIOLOGY OF RESPIRTORY SYSTEM:
Nose:
The nose is the first of the respiratory passage through which the inspired air passes. The function of the nose is to begin the process by which the air is warmed, moistened and filtered.
Pharynx:
The pharynx is an organ involved in both the respiratory and the digestive system, air passes through the nasal and oral parts.
Larynx:
Air passage between the pharynx and Trachea, inspired air travels through the larynx.
Trachea:
These continue as in the nose, although air is normally saturated at
The diameter of the respiratory passages may be altered by contraction or relaxation of the involuntary muscles in their walls, thus regulating the volume of air entering the lungs. These changes are controlled by the autonomic nerve supply, parasympathetic stimulation causes constriction &
sympathetic stimulation causes dilatation.
Functions are:
Warming and humidifying Support and patience
Removal of particulate matter Cough reflex.
Bronchioles and Alveoli:
Generally the ciliated epithelium, goblet cells are phagocytic in nature.
These cells are most active in the distal air passages where ciliated epithelium has been replaced by flattened cells.
Lungs:
There are two in number. One lying on each side of the midline in the thoracic cavity. They are cone-shaped and are having,
The apex The base
The costal surface The medial surface
Structures which form the root of the lung enter and leaves at the hilum. These include,
The primary bronchus The pulmonary artery Two pulmonary veins
ANATOMY OF THE RESPIRATORY SYSTEM
Organisation of the Lungs:
The right lung is divided into three distinct lobes:
Superior Middle Inferior
The left lung is smaller as the heart is situated left of the midline. It is divided into only two lobes:
Superior Inferior Pleura:
The pleura consists of a closed sac of serous membrane one for each lung, which contains a small amount of serous fluid.
The pleura has 2 layers.
1. The visceral pleura-Adherent to the lung & covers each lobe 2. The parietal pleura – Adherent to the inner aspect of chest wall
and thoracic surface of the diaphragm.
Pleural Cavity:
A potential space lies between 2 layers of pleura. In this space a thin flim of serous fluid secreted by the epithelial cells present and it prevents the friction of layers during breathing.
INFECTIONS AND INFLAMMATORY DISORDER:
Inflammation of respiratory tract can be caused by inhaling irritants, but is commonly due to infection. Such infections are usually caused by viruses that lower the resistance of the respiratory tract to other infections. This allows bacteria dormant in the tract to invade the tissues results in inflammatory swelling and such infections are threat to life, this exudates block the airway, because they spread to the lungs or other organs.
Microbes are usually spread by droplet infections, in dust or by contaminated equipment and dressings. If not completely resolved, acute infection may become chronic. Secondary infection by bacteria usually results in purulent discharge.
- Anatomy & physiology in Health & Illness (Rose and Wilson) – 9th Edition (P.No: 240-258).
Childhood type of tuberculosis is more along the posterior segment of the upper lobe or apical and posterior segments of the lower lobe. T.B.
bacilli are aerobic organisms. They require plasma O2 of 140mm of Hg. In the above areas the PO2 is about 120-130mm of Hg. That is why these bacteriae prefer such sites.
- Fundamentals of human Anatomy (Regional &Applied) Vol-II Thorax &
Abdomen (A.S.MONI) (P.No:16) Correlation of the General features of kanam with modern aspect:
General Symptoms:
!! Lgk<kqz<!uqbi<ju!! ! ! .!!!!Sweating over face
!! ds<sqbqz<!GpquqPkz<!!! !! .!!! Sunken fontanelle
!! g{<!ouV{<M!hiIk<kz<!! !! .!!! Anxious look
!! jggt<?!giz<gt<?!Lgl<!gXk<kz<! .!!! Flacky paint dermatosis
!
!! jg?!giz<?!Lgl<!wiqkz<!! !!! .!! Burning sensation of whole body especially
face and extremities !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!! lbg<gl<! ! ! ! !! .!!! Syncope Respiratory Symptoms:
!! Olz<&s<S!!!! ! ! !! . Dyspnoea
!! -Vlz<!! !! ! !! !! .!!! Cough
!! ohiXk<K!ohiXk<K!Svl<!!! !! .!!! Intermittend fever.
dm<Svl<!! ! ! ! !! ! .!!! Feverish feeling
!! liIH!%l<HOhiz<!wPl<hq!gi{z<!! ! .!!! Pigeon chest.
Gastro Intestinal Tract symptoms:-
!! fi!Oug<giM!!! ! ! ! ! .!!! Ulceration of Tongue uib<!dzVl<!!! ! ! ! ! .!!! Dryness of mouth
fQIOum<jg!!! ! ! ! ! .!! Thirst
!! uib<fix<xl<!!! ! ! ! ! .!!! Halitosis
ubqX!OfiU!! ! ! ! ! .!!! Abdominal
discomfort or abdominal pain
!! ubqX!gpqkz<!!! ! ! ! ! .!!! Diarrhoea sQkligUl<!-vk<kligUl<!Ohkq!! ! .!!! Dysentry.
!! lzl<!w{<o{b<!gsqUt<tkig!-Vk<kz<!! .!!! Steatorrhoea.
De<!gPuqb!k{<{QI?!hiz<!Ohiz!Ohkqbikz<.!Indigested food.
The general symptoms of kanam may be correlated with childhood type of tuberculosis in modern system.
TUBERCULOSIS IN CHILDREN
Tuberculosis is a common infectious disease caused by mycobacterium tuberculosis. It is one of the deadliest diseases in the world killing nearly 2 million people every year. In that more than 90% of all tuberculosis cases occur in developing countries.
Tuberculosis infection and disease among children are much more prevalent in developing countries because resources for control are limited.
It is estimated that in developing countries the annual risk of tuberculosis infection in children is 2-5%. The estimated lifetime risk of developing tuberculosis disease for a young child infected with tuberculosis as indicated by positive tuberculin test in about 10%.
